臼杯边缘与髋臼骨性边缘位置关系影像解剖学研究

doi:10.13418/j.issn.1001-165x.2021.03.010

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中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (3) : 297-301. DOI: 10.13418/j.issn.1001-165x.2021.03.010

断层影像解剖

臼杯边缘与髋臼骨性边缘位置关系影像解剖学研究

周雪明¹，　黄桂武²，　刘彬¹，　谢荏棠¹，　邬培慧²，　吴润柏¹

作者信息 +

Anatomical study on the relationship between the edge of the acetabular cup and the edge of the osseous acetabulum

Zhou Xueming¹, Huang Guiwu², Liu Bin¹, Xie Rentang¹, Wu Peihui² , Wu Runbai¹

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摘要

目的　利用影像资料构建骨盆三维模型，探究臼杯边缘与髋臼骨性边缘的解剖位置关系，辅助全髋关节置换术中徒手臼杯定位。方法　选取正常髋臼及Crowe Ⅱ/Ⅲ型DDH患者髋臼的CT断层图像，使用三维规划软件BOHOLO模拟全髋关节置换术植入目标臼杯（方位：前倾角20 °，外展角40 °，骨床-臼杯覆盖率＞75%），在右侧髋臼的1、4、7、10点钟4个方向，测量臼杯外露长度即臼杯边缘与髋臼骨性边缘的距离，并作统计分析。结果　对于正常髋臼及Crowe Ⅱ/Ⅲ型DDH髋臼，臼杯目标方位的垂直高度分别为（16.26±0.93）mm，（22.09±4.10）mm；各方向髋臼边缘外露长度，髋臼正常组与DDH组有统计学差异（P＜0.05），正常髋臼后下壁（右髋7点钟，左髋5点钟）的外露长度为（9.71±1.68）mm，变异度较小，不同性别、年龄无明显差异。结论　髋臼后下壁的外露长度可作为正常臼杯定位相对恒定的解剖学参照，据此原位重建臼杯可获得满意的骨床-臼杯覆盖率，而对于Crowe Ⅱ/Ⅲ型患者，各向髋臼骨缘外露长度的变异较大。

Abstract

Objective　To explore the anatomical positional relationship between the edge of the acetabular cup and the edge of the osseous acetabulum by utilizing the imaging data to reconstruct pelvis 3D model, and to improve the accuracy of intraoperative freehand acetabular cup orientation. Methods Based on the CT data of normal acetabulum and Crowe Ⅱ/Ⅲ DDH acetabulum, 3D planning software was used to stimulate the implantation of target acetabular cup in total hip arthroplasty (orientation: anteversion angle was 20°, abduction angle was 40°, acetabular bony coverage rate was more than 75%). In the 1，4，7，10 o’clock four directions of the right acetabulum, the exposed length of the acetabulum cup, which was the distance between the edge of the acetabular cup and the bony edge of the acetabular, was recorded and statistically analyzed. Results The optimal vertical height of the cup implantation for normal acetabulum and Crowe type Ⅱ/Ⅲ DDH acetabulum were (16.26±0.93) mm and (22.09±4.10)mm, respectively. There was statistical differences (P<0.05) between the normal group and the DDH group of exposed length in four directions. The exposed length of the posterior inferior wall of the normal acetabulum (7 o 'clock direction in the right hip, 5 o 'clock direction in the left hip) was (9.71±1.68) mm. The coefficient of variation of the exposed distance in other directions has no obvious difference in different genders and ages. Conclusions The exposed length of the posterior inferior acetabular wall is relatively constant to be utilized as an anatomical reference landmark for THA in normal acetabulum, while for Crowe type II/III patients, there is a great variation in the length of the acetabulum edge exposure in all directions.

导出引用

周雪明, 黄桂武, 刘彬, 谢荏棠, 邬培慧, 吴润柏. 臼杯边缘与髋臼骨性边缘位置关系影像解剖学研究[J]. 中国临床解剖学杂志. 2021, 39(3): 297-301 https://doi.org/10.13418/j.issn.1001-165x.2021.03.010

Zhou Xueming, Huang Guiwu, Liu Bin, Xie Rentang, Wu Peihui , Wu Runbai. Anatomical study on the relationship between the edge of the acetabular cup and the edge of the osseous acetabulum [J]. Chinese Journal of Clinical Anatomy. 2021, 39(3): 297-301 https://doi.org/10.13418/j.issn.1001-165x.2021.03.010

中图分类号： R323.5 R687.42　

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